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Drug Overdose

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https://www.readbyqxmd.com/read/29778489/trends-in-non-medical-prescription-opioids-and-heroin-co-use-among-adults-2003-2014
#1
Sasha Mital, Michael Windle, Hannah L F Cooper, Natalie D Crawford
BACKGROUND: Patterns in non-medical prescription opioid (NMPO) and heroin use have recently shifted, with evidence that NMPO-only users transition to NMPO and heroin co-use. Co-use is associated with increased risk of morbidity and overdose, highlighting the need for further investigation. This study aims to quantify, describe, and explore trends in co-use. METHODS: Using data from the 2003-2014 National Surveys on Drug Use and Health, we compared co-use to NMPO- and heroin-only use across demographic, substance use and mental health characteristics with chi-squared tests...
May 16, 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/29776688/naloxone-laws-facilitate-the-establishment-of-overdose-education-and-naloxone-distribution-programs-in-the-united-states
#2
Barrot H Lambdin, Corey S Davis, Eliza Wheeler, Stephen Tueller, Alex H Kral
BACKGROUND: The opioid overdose crisis in the United States continues to worsen. Opioid overdose mortality is entirely preventable with timely administration of naloxone. Since 2001, many states have passed laws to create an enabling environment for the implementation of overdose education and naloxone distribution (OEND) programs. We assessed whether state-level naloxone laws and their provisions stimulated the implementation of OEND programs in the United States. METHODS: Covering the period from 2000 to 2014, we utilized five data sources including the Westlaw legal database, the Prescription Drug Abuse Policy System, the Harm Reduction Coalition's OEND database, National Center of Health Statistics and the United States Census...
May 12, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29772071/to-test-or-not-to-test-the-value-of-toxicology-in-a-delayed-overdose-death
#3
Erin E Walsh, Elisa N Shoff, Mary Elizabeth Zaney, George W Hime, Fintan Garavan, Diane M Boland
A case demonstrating the necessity of thorough death investigation processes where toxicology plays an active role is presented. A 33-year-old white man presented to the emergency room in respiratory distress after an overdose episode where he was revived on the scene by fire rescue. His condition continued to deteriorate and he expired 6 days after the initial incident. No admission specimens were available for testing; however, there were specimens drawn 4 and 5 days after the incident. Drug paraphernalia from the scene was obtained by the laboratory through collaboration with local law enforcement...
May 17, 2018: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/29771745/national-institute-on-drug-abuse-international-program-improving-opioid-use-disorder-treatment-through-international-research-training
#4
Steven W Gust, Judy McCormally
PURPOSE OF REVIEW: For more than 25 years, the National Institute on Drug Abuse (NIDA) has supported research-training programs, establishing a global research network and expanding the knowledge base on substance use disorders. International research to inform approaches to opioid addiction is particularly important and relevant to the United States, where opioid misuse, addiction, and overdose constitute an emerging public health crisis. This article summarizes the NIDA International Program and illustrates its impact by reviewing recent articles about treatment approaches for opioid use disorders (OUD)...
May 15, 2018: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/29769209/time-to-event-bayesian-optimal-interval-design-to-accelerate-phase-i-trials
#5
Ying Yuan, Ruitao Lin, Daniel Li, Lei Nie, Katherine E Warren
Late-onset toxicity is common for novel molecularly targeted agents and immunotherapy. It causes major logistic difficulty for existing adaptive phase I trial designs, which require the observance of toxicity early enough to apply dose escalation rules for new patients. The same logistic difficulty arises when the accrual is rapid. We propose the time-to-event Bayesian optimal interval (TITE-BOIN) design to accelerate phase I trials by allowing for real-time dose assignment decisions for new patients while some enrolled patients' toxicity data are still pending...
May 16, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29769132/toots-tastes-and-tester-shots-user-accounts-of-drug-sampling-methods-for-gauging-heroin-potency
#6
Sarah G Mars, Jeff Ondocsin, Daniel Ciccarone
BACKGROUND: Internationally, overdose is the primary cause of death among people injecting drugs. However, since 2001, heroin-related overdose deaths in the United States (US) have risen sixfold, paralleled by a rise in the death rate attributed to synthetic opioids, particularly the fentanyls. This paper considers the adaptations some US heroin injectors are making to protect themselves from these risks. METHODS: Between 2015 and 2016, a team of ethnographers collected data through semi-structured interviews and observation captured in field notes and video recording of heroin preparation/consumption...
May 16, 2018: Harm Reduction Journal
https://www.readbyqxmd.com/read/29766592/scoring-the-best-deal-quantity-discounts-and-street-price-variation-of-diverted-oxycodone-and-oxymorphone
#7
Jacob A Lebin, David L Murphy, Stevan Geoffrey Severtson, Gabrielle E Bau, Nabarun Dasgupta, Richard C Dart
BACKGROUND: Diverted prescription opioids are significant contributors to drug overdose mortality. Street price has been suggested as an economic metric of the diverted prescription opioid black market. This study examined variables that may influence the street price of diverted oxycodone and oxymorphone. METHODS: A cross-sectional study was conducted utilizing data from the previously validated, crowdsourcing website StreetRx. Street price reports of selected oxycodone and oxymorphone products, between August 22, 2014 and June 30, 2016, were considered for analysis...
May 15, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29766381/impact-of-drug-overdose-deaths-on-solid-organ-transplantation-in-the-united-states
#8
George Cholankeril, Andrew A Li, Rosann Cholankeril, Alice E Toll, Jeffrey S Glenn, Aijaz Ahmed
No abstract text is available yet for this article.
May 15, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29766045/post-stroke-intranasal-naloxone-delivery-reduces-microglial-activation-and-improves-behavioral-recovery-from-ischemic-injury
#9
Jenni E Anttila, Katrina Albert, Emily S Wires, Kert Mätlik, Lisa C Loram, Linda R Watkins, Kenner C Rice, Yun Wang, Brandon K Harvey, Mikko Airavaara
Ischemic stroke is the leading cause of disability, and effective therapeutic strategies are needed to promote complete recovery. Neuroinflammation plays a significant role in stroke pathophysiology, and there is limited understanding of how it affects recovery. The aim of this study was to characterize the spatiotemporal expression profile of microglial activation and whether dampening microglial/macrophage activation post-stroke facilitates the recovery. For dampening microglial/macrophage activation, we chose intranasal administration of naloxone, a drug that is already in clinical use for opioid overdose and is known to decrease microglia/macrophage activation...
March 2018: ENeuro
https://www.readbyqxmd.com/read/29765983/a-clinical-study-of-toxication-caused-by-carbamazepine-abuse-in-adolescents
#10
Wei Xu, Yu-Lin Chen, Ying Zhao, Li-Jie Wang, Jiu-Jun Li, Chun-Feng Liu
Carbamazepine is known to produce the side effect of euphoria. As such, it lends itself to being a drug of abuse, particularly in the adolescent population. This retrospective study evaluated carbamazepine abuse, treatment course, and associated morbidity in Chinese adolescents. The median dose of carbamazepine resulting in overdose was 2,000 mg (800-5,000). Patients were largely from urban-rural fringe areas (76.47%, 52.94%) with school performance within the last 1/3 range and (52.94%) unsupervised by parents...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29762260/clinical-indications-associated-with-opioid-initiation-for-pain-management-in-ontario-canada-a-population-based-cohort-study
#11
Sachin V Pasricha, Mina Tadrous, Wayne Khuu, David N Juurlink, Muhammad M Mamdani, J Michael Paterson, Tara Gomes
Concerns over prescription opioids contributing to high levels of opioid use disorder and overdose have led policymakers and clinicians to seek means to reduce inappropriate and high-dose initial prescriptions. To inform such efforts, we sought to describe the clinical indications associated with opioid initiation and the characteristics of the initial prescriptions and patients through a retrospective population-based cohort study. Our cohort included Ontarians initiating prescription opioids for pain management between April 1, 2015, and March 31, 2016...
May 14, 2018: Pain
https://www.readbyqxmd.com/read/29758542/fentanyl-self-testing-outside-supervised-injection-settings-to-prevent-opioid-overdose-do-we-know-enough-to-promote-it
#12
Catherine R McGowan, Magdalena Harris, Lucy Platt, Vivian Hope, Tim Rhodes
Since 2013, North America has experienced a sharp increase in unintentional fatal overdoses: fentanyl, and its analogues, are believed to be primarily responsible. Currently, the most practical means for people who use drugs (PWUD) to avoid or mitigate risk of fentanyl-related overdose is to use drugs in the presence of someone who is in possession of, and experienced using, naloxone. Self-test strips which detect fentanyl, and some of its analogues, have been developed for off-label use allowing PWUD to test their drugs prior to consumption...
May 11, 2018: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29757920/alaska-nurse-practitioners-barriers-to-use-of-prescription-drug-monitoring-programs
#13
Heath Christianson, Elizabeth Driscoll, Aicha Hull
BACKGROUND AND PURPOSE: Prescription drug monitoring programs (PDMPs) have begun to demonstrate themselves as useful tools in enhancing safe and responsible prescription of controlled substances. The purpose of this project was to describe current practice, beliefs, and barriers of Alaska nurse practitioners (NPs) regarding the Alaska PDMP. METHODS: A questionnaire was sent to 635 Alaskan NPs with a 33% return rate. The data depicted prescribing habits, barriers to use, barriers to registering, and opinions on how to make the PDMP more clinically useful...
January 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29757475/rapid-analysis-of-fentanyls-and-other-novel-psychoactive-substances-nps-in-substance-use-disorder-patient-urine-using-paper-spray-mass-spectrometry
#14
Joseph H Kennedy, Jan Palaty, Chris G Gill, Justin M Wiseman
RATIONALE: Drug overdose deaths due to fentanyls and other novel psychoactive substances (NPS) are on the rise. The higher potencies of fentanyl analogs compared with morphine require new technologies to identify and quantitate NPS. METHODS: Paper spray tandem mass spectrometry and high-resolution mass spectrometry were used to identify and measure fentanyl analogs as well as common drugs of abuse in urine samples from substance use disorder clinics. Ten-microliter urine samples were deposited directly on paper spray cartridges previously loaded with internal standards, dried, and analyzed with no other sample treatment...
May 14, 2018: Rapid Communications in Mass Spectrometry: RCM
https://www.readbyqxmd.com/read/29753208/mechanisms-of-acetaminophen-induced-liver-injury-and-its-implications-for-therapeutic-interventions
#15
REVIEW
Mingzhu Yan, Yazhen Huo, Shutao Yin, Hongbo Hu
Acetaminophen (APAP) overdose is the leading cause of drug-induced acute liver failure in many developed countries. Mitochondrial oxidative stress is considered to be the predominant cellular event in APAP-induced liver injury. Accordingly, N-acetyl cysteine, a known scavenger of reactive oxygen species (ROS), is recommended as an effective clinical antidote against APAP-induced acute liver injury (AILI) when it is given at an early phase; however, the narrow therapeutic window limits its use. Hence, the development of novel therapeutic approaches that can offer broadly protective effects against AILI is clearly needed...
April 22, 2018: Redox Biology
https://www.readbyqxmd.com/read/29751889/gender-and-geographical-inequalities-in-fatal-drug-overdose-in-iran-a-province-level-study-in-2006-and-2011
#16
Mehran Rostami, Mohammad Karamouzian, Ardeshir Khosravi, Shahab Rezaeian
AIM: We aimed to compare the fatal drug overdose rates in Iran in 2006 and 2011. METHODS: This analysis was performed based on data on fatal drug overdose cases from the Iranian death registration system. The crude and adjusted rates per 100,000 populations for geographical regions stratified by gender and age groups were calculated using the 2006 and 2011 census of Iranian population. Annual percentage change was calculated to examine annual changes of fatal drug overdose rates across different regions...
June 2018: Spatial and Spatio-temporal Epidemiology
https://www.readbyqxmd.com/read/29751092/overdosing-of-benzodiazepines-z-drugs-and-falls-in-older-adults-costs-for-the-health-system
#17
María José Díaz-Gutiérrez, Mónica Martínez Cengotitabengoa, Cristina Bermúdez-Ampudia, Sainza García, Purificación López, Mayte Martínez-Cengotitabengoa, Ana González-Pinto
INTRODUCTION: Benzodiazepines and Z drugs (BZD/Z drugs) are commonly used for the treatment of insomnia and anxiety in older adults for long periods of time. Given the physiological and metabolic characteristics of this group of patients, they are more prone to the adverse effects of these drugs which include falls. The recommendations for use of BZD/Z drugs include the need to adjust the dose and select those with a short half-life, to avoid adverse events, which as well as potentially affecting patient outcome, increase healthcare costs...
May 8, 2018: Experimental Gerontology
https://www.readbyqxmd.com/read/29748533/p53-attenuates-acetaminophen-induced-hepatotoxicity-by-regulating-drug-metabolizing-enzymes-and-transporter-expression
#18
Jiahong Sun, Yajie Wen, Yanying Zhou, Yiming Jiang, Yixin Chen, Huizheng Zhang, Lihuan Guan, Xinpeng Yao, Min Huang, Huichang Bi
Acetaminophen (APAP) overdose is the most frequent cause of drug-induced acute liver failure. Inhibition of APAP metabolic activation and promotion in APAP disposition are important to protect against APAP-induced liver injury. Tumor suppressor p53 is traditionally recognized as a surveillance molecule to preserve genome integrity. Recent studies have emerged on discovering its functions in metabolic regulation. Our previous study reported that p53 promoted bile acid disposition and alleviated cholestastic syndrome...
May 10, 2018: Cell Death & Disease
https://www.readbyqxmd.com/read/29747875/young-adults-opioid-use-trajectories-from-nonmedical-prescription-opioid-use-to-heroin-drug-injection-drug-treatment-and-overdose
#19
Honoria Guarino, Pedro Mateu-Gelabert, Jennifer Teubl, Elizabeth Goodbody
INTRODUCTION: Recent research has begun to explore the transition from nonmedical use of prescription opioids (POs) to heroin and injection drug use, adding to earlier literature identifying factors that influence the transition from intranasal to injection use of heroin. However, little research has explored how these transitions are embedded within young people's broader opioid use trajectories - individual pathways that may also include experiences of nonfatal overdose and drug treatment...
May 1, 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/29746453/access-to-syringe-services-programs-kentucky-north-carolina-and-west-virginia-2013-2017
#20
Danae Bixler, Greg Corby-Lee, Scott Proescholdbell, Tina Ramirez, Michael E Kilkenny, Matt LaRocco, Robert Childs, Michael R Brumage, Angela D Settle, Eyasu H Teshale, Alice Asher
The Appalachian region of the United States is experiencing a large increase in hepatitis C virus (HCV) infections related to injection drug use (IDU) (1). Syringe services programs (SSPs) providing sufficient access to safe injection equipment can reduce hepatitis C transmission by 56%; combined SSPs and medication-assisted treatment can reduce transmission by 74% (2). However, access to SSPs has been limited in the United States, especially in rural areas and southern and midwestern states (3). This report describes the expansion of SSPs in Kentucky, North Carolina, and West Virginia during 2013-August 1, 2017...
May 11, 2018: MMWR. Morbidity and Mortality Weekly Report
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